Pulmonary mattress

ABSTRACT

A patient support surface including a cover defining an interior region, a layer of three dimensional material, located at the interior region, and an air circulation device disposed adjacent the layer of three dimensional material. The patient support surface includes at least one of a percussion device and a vibration device, located at the interior region.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional PatentApplication Ser. No. 60/941,092, filed May 31, 2007, which isincorporated herein by this reference.

The present application is also related to U.S. patent application Ser.No. 11/119,980, entitled PRESSURE RELIEF SURFACE, and U.S. patentapplication Ser. No. 11/119,991, entitled PATIENT SUPPORT HAVING REALTIME PRESSURE CONTROL, and U.S. patent application Ser. No. 11/119,635,entitled LACK OF PATIENT MOVEMENT MONITOR AND METHOD, and U.S. patentapplication Ser. No. 11/120,080, entitled PATIENT SUPPORT, all of whichwere filed on May 2, 2005, all of which are incorporated herein by thisreference.

The present application is also related to U.S. Provisional PatentApplication Ser. No. 60/636,252, entitled QUICK CONNECTOR FORMULTIMEDIA, filed Dec. 15, 2004, which is incorporated herein by thisreference.

The present application is also related to U.S. Provisional PatentApplication Ser. No. 60/697,748, entitled PRESSURE CONTROL FOR AHOSPITAL BED and corresponding PCT application No. PCT/US06/26787 filedJul. 7, 2006, and U.S. Provisional Patent Application Ser. No.60/697,708, entitled CONTROL UNIT FOR A PATIENT SUPPORT, andcorresponding PCT application No. PCT/US06/26788 filed Jul. 7, 2006, andU.S. Provisional Patent Application Ser. No. 60/697,748 entitled PATIENTSUPPORT and corresponding PCT Application No. PCT/US06/26620 filed Jul.7, 2006 and PCT application No. PCT/US05/14897 entitled PATIENT SUPPORTfiled May 2, 2005, all of which are incorporated herein by thisreference.

The present application is also related to U.S. Provisional PatentApplication Ser. No. 60/821,494, entitled PATIENT SUPPORT, which wasfiled on Aug. 4, 2006, the disclosure of which is incorporated herein bythis reference.

BACKGROUND

The present disclosure relates to support surfaces, such as mattresses.More particularly, the present invention relates to support surfacesused to support a patient on a bed frame, such as in a hospital or otherpatient care environment. Even more particularly, the present inventionrelates to support surfaces for patients that require pulmonary therapy.

Known hospital beds and mattresses are disclosed, for example, in U.S.Pat. No. 4,949,413 to Goodwin, U.S. Pat. No. 5,647,079 to Hakamiun etal., U.S. Pat. No. 5,731,062 to Kim et al., U.S. Pat. No. 6,269,504 toRomano et al., U.S. Pat. No. 6,701,556 to Romano et al., U.S. Pat. No.6,708,352 to Salvatini et al., and U.S. Pat. No. 6,820,630 to Hand etal., all of which are assigned to the assignee of the present inventionand all of which are incorporated herein reference herein in theirentirety.

SUMMARY OF THE INVENTION

The present invention may comprise one or more of the features recitedin the appended claims and/or one or more of the following features orcombinations thereof.

According to one aspect of the present invention there is provided apatient support surface including a cover defining an interior region, alayer of three dimensional material, located at the interior region, thethree-dimensional material including a network of thermoplastic fibers,an air circulation device disposed adjacent the layer of threedimensional material, and at least one of a percussion and a vibrationdevice, located at the interior region.

According to another aspect of the present invention there is provided apatient support surface including a cover defining an interior region, alayer of three dimensional material, located at the interior region, thethree-dimensional material including a network of thermoplastic fibers,an air circulation device disposed adjacent the layer of threedimensional material, and a hose, located at the interior region,including at least one connector adapted to couple to an externaldevice.

Pursuant to another aspect of the present invention there is provided ahospital bed including a frame, to support a patient, and a supportsurface; located on the frame. The support surface includes a coverdefining an interior region and a layer of three dimensional material,located at the interior region. The three-dimensional material includesa network of thermoplastic fibers, an air circulation device disposedadjacent the layer of three dimensional material, and at least one of apercussion and a vibration device, located at the interior region.

According to still another aspect of the present invention there isprovided a patient support surface having a head end and a foot end. Thepatient support surface includes a cover defining an interior region, alayer of three dimensional material, located at the interior region, thethree-dimensional material including a network of thermoplastic fibers,an air circulation device disposed adjacent the layer of threedimensional material, and a head elevation device, located at the headend of the patient support surface, the head elevation device includinga support surface to elevate the head end of the patient supportsurface.

Features and other aspects of the present disclosure will becomeapparent to those skilled in the art upon consideration of the followingdetailed description of illustrative embodiments, which exemplify thebest mode as presently perceived.

BRIEF DESCRIPTION OF THE DRAWINGS

The detailed description particularly refers to the accompany figures inwhich:

FIG. 1 illustrates a perspective view of a pressure relief supportsurface including a slot for an x-ray cassette;

FIG. 2 illustrates an exploded perspective view of a multi-layeredpressure relief support surface;

FIGS. 3, 4, and 5 illustrate a perspective view a pressure reliefsupport surface and an x-ray cassette at is passes through a slot;

FIG. 6 illustrates a perspective view of a multi-layered pressure reliefsupport surface including percussion and vibration bladders;

FIG. 7 illustrates an exploded perspective view of sensors with respectto cushion sections;

FIG. 8 illustrates a perspective view of a multi-layered pressure reliefsupport surface with turn assist bladders;

FIG. 9 illustrates a sectional view of the support surface of FIG. 1along a line 9-9;

FIGS. 10-12 illustrate perspective view of a controller including userinterface;

FIG. 13 illustrates a perspective view of an airway clearance systemintegrated with a pressure relief support surface through a controlunit;

FIG. 14 illustrates a perspective view of an airway clearance systemintegrated directly with a pressure relief support surface;

FIG. 15 illustrates a perspective view of a control unit with a holderfor a deep vein thrombosis device;

FIGS. 16-18 illustrate user interface screens of the present invention;

FIG. 19 illustrates an end view of one embodiment of an elevationdevice;

FIG. 20 illustrates a side view of one embodiment of an elevationdevice;

FIG. 21 illustrates a schematic illustration of FIG. 19;

FIG. 22 illustrates a pressure relief support surface and a frameincluding integrated device;

FIG. 23 illustrates a block diagram of a control and communicationsystem; and

FIGS. 24-30 illustrate additional user interface screens of the presentinvention.

DETAILED DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a perspective view of a pressure relief supportsurface 10, or mattress, including a slot 26 for inserting an x-raycassette 27. The pressure relief support surface 10 includes a cover 12which surrounds a plurality of components to be described later herein.The cover 12 includes a top surface 14 and a bottom surface 16, each ofwhich is coupled together by longitudinal sides 18 and 20. A first endportion 22 located at a head end 23 of the surface 10 and a second endportion 24 located at a foot end 25 of the surface 10 complete the cover12. Slot 26 includes an aperture located along at least one of thelongitudinal sides 18, 20. Slot 26 provides for placement of an x-raycassette 27 beneath the top surface 14 of the cover 12.

Such pressure relief support surfaces are typically used in health carefacilities such as hospitals, nursing homes, and extended carefacilities. The use of such surfaces is not limited to such facilities,however, and can be used where there is a need, including the home.

In the illustrated embodiment, the slot 26 extends from one side 18 ofsurface 10 to the other side 20. The slot 26 includes a second aperturelocated along the longitudinal side 20 and provides for passage of thex-ray cassette 27 from a first side 18 of the mattress 10 to a secondside 20 of the mattress 10. The interior region of the slot 26, locatedbetween sides 18, 20 of the mattress 10, includes a low frictionmaterial to facilitate insertion and removal of the x-ray cassette 27without disturbing a patient positioned on the mattress 10. The slot 26includes a length, L, which is greater than a width, W, of the x-raycassette 27. In addition, the longitudinal slot 26 is disposed along acentral portion of the support surface 10. Accordingly, that the x-raycassette 27 can be positioned at a number of locations along the supportsurface and beneath a patient. While the longitudinal slot 26 is showndisposed towards a central portion of the support surface 10, thelongitudinal slot can be disposed closer to the head end or the foot endportions of the support surface 10. Additional slots can be included aswell. Also, the length L of the slot is not fixed but can be selected toaccommodate a variety of sizes of x-ray cassettes 27 as well as toaccommodate a variety of positions of the x-ray cassette 27 beneath apatient. For instance, the slot 26 as illustrated enables the caregiverto position the x-ray cassette 27 along or underneath the torso portionof a patient.

The pressure relief support surface 10 includes a head of bed indicator30. The head of bed indicator 30 includes a light 32 or otherillumination device which indicates when the head of the bed (HOB)elevation passes a certain predetermined elevation. In one instance,when the head of bed elevation passes thirty degrees, the indicator 32will light thereby indicating that the desired elevation has beenreached. Because the pressure relief support service 10 can be used onany number of bed frames, including those which are fixed in ahorizontal plane and those which are continuously or partiallyadjustable, the head of bed indicator 30 can be either permanently ordetachably coupled to the support surface 10.

FIG. 2 illustrates an exploded perspective view of the multilayeredpressure relief support surface 10. As illustrated in FIG. 2, the cover12 including the slot 26 is shown at the bottom of the figure and isseparated from the remaining layers or components of the pressure reliefsupport surface 10. A perimeter cushion system is disposed within thecover 12 and includes a first section or portion 40, a second section orportion 42, and a third section or portion 44. The perimeter cushionsystem provides a side and end support of the support surface 10 suchthat a patient subjected to either turn assist or rotational therapy, tobe described later herein, can be cradled to help maintain the patient'slocation within a central portion of the surface 10.

The first section 40 includes a plurality of pieces as illustrated eachof which can be either completely separated from an adjacent piece orcoupled thereto but still including therebetween a separation line. Theuse of distinct individual pieces either completely separated or coupledto adjacent pieces provides for articulation of the support surface 10when used on an articulateable frame. As can be seen, the first section40 includes first and second end portions 46, first and second head endportions 48, first and section foot end portions 50, first and secondthigh portions 52, and first, second, third, and fourth middle portions54. While a predetermined number of individual portions are illustrated,it is possible to incorporate more or less portions than shown dependingon the application of the mattress and its use with a bed frame.

Each of the portions 48, 50, 52, and 54 include an angled side wallwhich creates an interfacing surface with angled side walls of theindividual portions of the second section 42. The second section 42includes first and second head end portions 56, first and second footend portions 58, first and second thigh portions 60, and first, second,third, and fourth middle portions 62.

Each of the portions of the second section 42 include angled side wallswhich cooperate with and which contact the angled side walls of theportions of the first section 40 corresponding thereto. The height ofthe portions of the second section 42 are less than the height of theindividual portions of the first section 40. When the second section 42is placed within the first section 40, each of the portions 42 cooperateto define a substantially horizontal surface 64 upon which the thirdsection 44 can be placed.

The third section 44 includes a plurality of perimeter bolstersincluding first and second head end portions 66, first and second footend portions 68, first and second head end side portions 70, first andsecond foot end side portions 72, first and second thigh portions 74,and first, second, third and fourth middle portions 76. Each of theportions of the third section 44 are separable from adjacent portions orare coupled for flexibility when used with an articulated deck. Inaddition, the first and second parts of the portion 66 are spaced apartto define a gap 67 and a similar space or gap 69 exists between thefirst and second portions 68. When the first section 40, the secondsection 42, and the third section 44 are assembled together, the space67 between the portions 66 and the space 69 between the portions 68correspond to spaces, respectively 80 and 82 of the first section. Thespaces 67, 69, 80 and 82 define an aperture to locate a first aircirculation device or fan 84 and a second fan or circulation device 86,to be described later herein.

A plurality of pressure sensors 88 are located and disposed aboveturning/rotation air bladders 90 and 92. Force sensing transducers canalso be used. The turning/rotation bladders 90 and 92 provide forturning a patient and/or rotating a patient under continuous lateralrotation as would be understood by one of ordinary skill in the art. Theplurality of pressure sensors 88 include a first section 94, a secondsection 96, a third section 98, a fourth section 100, and a fifthsection 102. Each of the plurality of pressure sensor sections provide asingle signal which indicates a pressure amount being supported byrespective sections 110 of air cushions. In particular, each section 110can include a plurality of upstanding air cushions having a cylindricalshape. Other types of cushions or bladders are possible.

Each of the sections of upstanding cells or air cushions includes aplurality which is disposed directly upon a corresponding pressuresensor section. Consequently, when a patient lies upon the pressurerelief support surface 10, patient pressures upon different portions ofthe surface 10 can be individually determined by the pressure or forcesensor located therebelow. Consequently, pressures for head portions,upper body portions, middle portions, side portions, and leg portions,and other portions of a patient can be individualized for each patient'sbody.

Each of the sections 110 of cells includes upstanding cylinders orinflatable cushions which have spaces disposed therebetween. Within thespaces of the upper body section, a thermo-regulation device 112 can bedisposed. The device 112 provides for thermal regulation of a patientand can cool and warm a patient. The device 112 can include any numberof thermal regulation mechanisms, however, the present device 112includes a plurality of fluid filled or water filled chambers which aredisposed between the spaces of the head end section 110 for the upperbody portion. As fluid or water is moved through the thermal regulationdevice 112, it is circulated beneath a patient to provide cooling orheating to the patient's upper body. Fluid flow or water flow can movein one direction throughout the device, as would be understood by oneskilled in the art, and passes through a controlling device (not shown)which includes a pump and a mechanism for thermal regulation of thefluid.

A topper 114 is located above the sections 110. The topper includes athree dimensional material or a three dimensional fiber network made ofa breathable fabric or other known three dimensional materials. One suchmaterial is known as SPACENET® material. For a further discussion ofthree dimensional materials, see U.S. Pat. Nos. 7,191,482; 6,701,556;and 6,269,504; all of which are incorporated by reference herein intheir entirety.

The three dimensional material 114 enables the air circulators 84 and 86to circulate air through the topper 114. The air circulators 84 and 86can be configured such that one of the circulators 86 is used to pushair through the topper and the other air circulator is used to pull airthrough the topper. Consequently, air flow can be directed in a singledirection.

A percussion and vibration system 116 is included and disposed at anupper body portion of the support surface 10. The percussion andvibration system provides for the percussion and vibration of a chestportion of a patient as is understood by one of ordinary skill in theart. Percussion and vibration systems are known and can include aplurality of air bladders, three of which are illustrated.

FIGS. 3, 4, and 5 illustrate a partial perspective view of the x-raycassette 27 as it passes through the slot 26. While FIGS. 3 and 4 do notillustrate one of the portions of the topper 114, the x-ray cassette 26when in use can be located above the upper body portion of the topper114.

FIG. 6 illustrates a perspective view of the multi-layered pressurerelief support surface 10 without the cover 12. In this illustration,the percussion and vibration bladder 116 is located in the upper bodyportion of the mattress 10 to provide percussion and/or vibration to thechest area of a patient.

FIG. 7 illustrates the arrangement of the pressure sensors 88 withrespect to the cushion sections 110. The individual sections 110 havebeen moved closer together to illustrate that the upstanding cushionswhen assembled provide a substantially continuous support surfacewithout gaps between sections as is illustrated in FIG. 2. Theindividual sections of the pressure sensors 88 have also been movedcloser together and the entire combination fits within the cavitydefined by the first section 40, second section 42, and third section 44of the perimeter cushion system of FIG. 2. In other embodiments,horizontal, laterally-oriented or log-shaped bladders may be used inplace of one or more of the upstanding cushion sections.

FIG. 8 illustrates the various portions and layers of FIG. 2 excludingthe cover 12 and the x-ray cassette 27. The turning/rotation bladders 90and 92 are substantially located within a central portion of themattress for providing turning as well as continuous lateral rotation.

FIG. 9 illustrates a sectional view of the support surface 10 of FIG. 1along a line 9-9. As previously described, and as seen here inadditional detail, the portions 58 are in contact with the portions 50of the first section 40 and define an interface therebetween along theangled side walls of each. The section 72 of the third section 44 sitsupon a substantially flat and horizontally disposed top surface of theportion 50. Also, as can be seen, the upstanding cushions 110 arelocated above the pressure sensors 102.

FIGS. 10-12 illustrate a controller 120 including a user interface 122.The user interface 122 is coupled to the controller 120 through aswiveling mechanism 124 which enables the 122 to lay substantially flatagainst a top portion 126 of the controller 120. The swiveling mechanism124 enables the pivoting screen to move about an axis substantiallyparallel to the long dimension of the controller 120. The swivelingmechanism also includes a rotating portion 128 which enables theinterface 122 to rotate about an axis substantially vertical withrespect to the plane of the top portion 126. The swiveling mechanism 124and rotating portion 128 in combination provide an adjustment capabilitywhich allows the pivoting interface to be moved in a variety ofpositions for improving access of the interface 122 to a user orcaregiver. The user interface can include a variety of selectors whichcan include touch screen selectors, pressure sensitive buttons, and/ormechanical switches. Other later described screens can include the sameselectors. The user interface can also include an electronic display,such as an liquid crystal diode (LCD) display which can display userinterface screens to be described later herein.

FIG. 13 illustrates a perspective view of an airway clearance system 130integrated with a support surface through a control unit 131. Themattress or support surface 10 is illustrated with the cover 12 but notincluding the slot 26, which can be optional. The airway clearancesystem 130 includes a high frequency chest wall oscillation device 132which is coupled to the control unit 131. One example of such a deviceis available from Hill-Rom, Inc. as The Vest® airway clearance system.

The control unit 131 provides for chest wall oscillation through the useof forced air which is moved through first and second tubes 136, 138which are coupled to the controller 131 through first and secondcouplers 140, 142. The tubes 136 and 138 are coupled to an upper bodyportion 144 which surrounds the chest wall and provides high frequencychest wall oscillations for the purpose of airway lung clearance andventilation as described in U.S. Pat. No. 6,736,785, which isincorporated in its entirety by reference herein.

As illustrated in FIG. 13, the controller 131 is coupled to the upperbody portion 144 and enables a patient or other user who may or may notbe located on the support surface 10 to use the airway clearance system130. For instance, when a patient is sufficiently mobile to move withina facility and to sit in a chair within a hospital room, the patient canwear the upper body portion 144 when seated in a chair. As furtherillustrated in FIG. 14, the controller 134 can also be coupled directlyto the support surface 10 through a hose 150. The hose 150 is coupled toa connector 152 which is in turn coupled to an internal hose device 154which passes through and is incorporated in the support surface 10. Afirst and a second connector 156 and 158 respectively terminate the hose150. Using this connection 156, 158 to couple to an external device, apatient lying with his or her head located at the head of the bed (HOB)can wear the upper body portion 144 when lying in bed to provide thechest wall oscillation. When controller 131 detects connection of anairway clearance system 132, controller 131 automatically disables orbypasses the mattress pulmonary therapy functions and the controlleruser interface 123 is automatically updated to visually indicate thestatus of a connection or disconnection of the airway clearance system.In this way, controller 131 can be used to control inflation anddeflation of bladder portions of mattress 10 and/or to control operationof the airway clearance system 132. As such, the need to providemultiple separate control units (i.e., a mattress controller and anairway clearance system controller) may be eliminated.

Alternatively or in addition, controller 131 is sized and shaped so thata separate airway clearance system controller is stackable on top of orunderneath controller 131, to thereby conserve space in the patient'shealthcare environment. Controller 131 may include all or a portion ofthe features of control unit 120 or control unit 160.

FIG. 15 illustrates a perspective view of a control unit 160 having aholder 162 which can be used to support a deep vein thrombosis device(DVT) 164 by insertion into holder 162 as indicated by arrow 163. A cuffis generally provided with DVT device 164 but is not illustrated. Thecontroller 160 includes a first attachment device 166 and secondattachment device 168. Devices 166, 168 can include a first and secondhook, which can be used to hang the controller 160 on a footboard,headboard, and/or side rail of a patient support frame. The controller160 includes a user interface 170 which is fixed and coupled to thecontroller 160. The DVT device 164 can be used to provide pneumaticpressure to a body limb to reduce or to prevent deep vein thrombosis.For additional details, please see U.S. Pat. No. 6,447,467 and U.S. Pat.No. 6,494,852 which are incorporated herein by reference in theirentirety.

FIGS. 16-18 illustrate various user interface screens displayed on auser interface 170 such as previously described. In the illustratedembodiments, a touch screen, including a liquid crystal display (LCD)and touch sensors are used, however, it will be understood by thoseskilled in the art that other suitable displays and/or input-outputdevices may also be used. Also, in the embodiment of FIGS. 16-18, statusinformation is generally displayed on the left-hand side of the screenwhile activatable buttons are generally located on the right-hand sideof the screen. Each of the tabs listed down the right-hand side of thescreen, i.e., “home”, “rotation”, “percussion”, “vibration”, “chestdevice”, “max inflate”, “turn assist”, and “opti-rest” relates toanother user interface screen comprising information anduser-activatable controls relating to the identified functionalcapabilities. In this way, all of the available functions are displayedat all times for easy access by the user. However, in the illustratedembodiment the screen that is currently in use or active is emphasizedor offset from the inactive screens by highlighting or contrastingcolor.

For example, as illustrated in FIG. 16, the user interface screenincludes a portion 171 which is entitled “HOME”. The “HOME” sectionenables a user to select certain tabs which initiate therapies. Thosetabs can include rotation, percussion, vibration, and chest devicecorresponding to the chest wall oscillation device. Additional tabs areprovided for adjusting mattress functions such as maximum inflate, turnassist, and Opti-rest. Opti-rest is a wave-like comfort modality withcushion pressures alternating to enhance patient comfort. A statussection 172 indicates the status of rotation, percussion and/orvibration depending on which tabs have been selected on the right handportion of the user interface 170.

As further illustrated in FIG. 17, should the rotation tab be selected,a rotation screen 170 indicates and provides the amount or percentage ofrotation for a right, a center, and a left position at a status area172. FIG. 17 illustrates an “empty” status area 172 in which nopulmonary therapy options have been initated. FIG. 18 illustrates astatus area 172 in which rotation percentages have been set and arotation therapy is in progress. In such event, status area 172indicates the amount of time remaining until the therapy is complete.

Slider bars, or arrows 173 and 174, can be used to select the desiredsettings. For instance, as illustrated in the right tab in which theright side of the body is lower than the left side, the rotation is setat 50% with the up down arrow 173. The pause time can be set to 15minutes with the up down arrow 174. An enter button 175 is provided tofinalize or to accept the settings made for pause and rotation. Inaddition to the right screen, a center screen and a left screen are alsoprovided which can be selected by touching the desired center or lefttab. As described with respect to the right screen, the rotationpercentage and pause time can be set for both center and left. Once theright, center and left settings have been selected, the enter button 175is selected to enter the data into the controller. The rotation screen,located below the status screen 172, indicates the values of rotation,pause, as well as time remaining. If either percussion and/or vibrationis selected, the settings are made similarly as described with respectto the rotation screen and entered as necessary with the enter button.Once entered, the status screen 172 which includes a section forpercussion and vibration shall illustrate the selected settings. A pausebutton 176 can be used to pause the selected treatments and then returnto those treatments by touching the pause button a second time. Also, ifit is desired to completely stop the selected treatment, the stop button177 can be selected to stop the selected treatment as well as to clearthe previously established settings.

The max inflate tab can be selected to inflate the cushions of thesupport system 10 to a maximum inflation, for instance, to enable apatient to enter and exit the bed more easily or to provide forcardio-pulmonary resuscitation. A turn assist tab is included and can beselected to elevate a left side or a right side of a patient to move apatient on one side or the other such that clothing and/or bed linenscan be changed or removed. An Opti-Rest tab can be pressed to providethe wavelike comfort modality.

FIG. 19 illustrates a head-end view of one embodiment of an elevationdevice 180, which may be used in place of turning/rotation bladders 90,92. The elevation device 180 has two hinge points 191 and 193 andthereby provides a function of alternatingly elevating each lateral sideof the head end of the support surface. The elevation device 180includes a bellows type of construction as illustrated in a side view ofFIG. 20 and a schematic view of FIG. 21. The elevation device 180 ofFIGS. 19-21, illustrated in FIG. 19 as an end view from the head end ofthe mattress and in FIG. 20 as a side view from one of the sides of themattress, includes first, second, third, and fourth compartments 182,184, 186, and 188. Each compartment 182, 184, 186, and 188 has a firstwidth 185, and a second width 187.

As shown in FIG. 21, an outer layer of the bellows 180 includes a firstlength L1 and an inner layer includes a length L2. Each compartment 182,184, 186, and 188 has length L2. The bellows 180 includes at least onefill port 190 which is used to fill the bellows or a portion thereofwith a fluid such as air. A reinforcer 192 is used around the outercompartments of the bellows 180 to help prevent distortion due topressure variations.

In the illustrated embodiment, device 180 is configured to elevate onelateral side of mattress 10, relative to the other side, and anotherdevice 180 may be positioned laterally adjacent the first device 180 toelevate the other lateral side of the mattress 10. For instance, oneinstance of device 180 is positioned to provide turning assistance orrotational therapy to a patient's left side while another instance ofdevice 180 is positioned opposite the first instance of device 180,across the width of the mattress 10, to provide turning assistance orrotational therapy to a patient's right side. In this embodiment, thefirst width 185 of compartments 182, 184, 186, 188 is larger than thesecond width 187 so that when fluid is provided through port 190 thebellows shape is created such that the height of the device 180 on theside of the compartments 182, 184, 186, 188 containing the first width185 is higher than the height of the device on the side containing thesecond width 187, in order to provide the specified turning or rotationangle “A”.

In one alternative embodiment, referred to herein as the “dual hinge”embodiment, reinforcer 192 also comprises an internal air flow barrieralong the dashed line between points 189 and 192 of FIG. 21, whichextends into the interior region of compartments 182, 184, 186, and 188to control air flow between first and second portions 195, 197 of thecompartments 182, 184, 186, and 188. As a result, air can be held ineither portion 195 or portion 197 to provide turning assistance, or aircan be alternatingly exchanged between portion 195 and 197 to providerotational therapy. In the dual hinged embodiment, when portion 195 ofcompartments 182, 184, 186, and 188 is inflated, device 180 is hinged atpoint 193. When portion 197 of compartments 182, 184, 186, and 188 isinflated, device 180 is hinged at point 191. In the dual hingedembodiment, first and second widths 185, 187 are substantially the same.

As can be seen in FIGS. 19 and 20, device 180 comprises a pair oflongitudinally spaced bellows 181, 183 that may be operable either inconcert or independently to provide turning assistance or rotationaltherapy. Each device 181, 183 includes a substantially rigid support194, 195, which rests upon the top portion of the bellows 180 and isheld thereto by straps 196, 197. The substantially rigid support 194provides for a supporting surface during elevation and rotation of thehead or torso portion of the patient support 10.

The device 180 is not limited to elevation of the head or torso, but mayalso be used to elevate the lower extremities if placed at the foot endof the support surface. For example, either or both of sections 181, 183of device 180 may be positioned underneath leg, calf or foot portions ofa patient, and portions 195, 197 may be alternatively inflated anddeflated, independently or at the same time, to exercise either or bothof the knee joints of a patient positioned on mattress 10.

In one embodiment, the elevation device 180 is constructed to provide anelevation of about thirty degrees from horizontal. Other elevations arealso possible, for example by inflating less than all of thecompartments 182, 184, 186, and 188. To achieve a greater degree ofrotation, i.e., in the range of about 45°, a portion of the surfacebladders 110 may be deflated under one side 195 while the oppositebellows 197 are inflated, or vice versa. In such event, one or moreperimeter bladders/supports 40, 42, 44 provide additional support to thenon-elevated side of the patient. A string potentiometer, one or moreball switches, or other suitable device may be operably connected to themattress and control unit to measure and monitor the degree of rotationprovided by the portions 181, 183 of device 180.

FIG. 22 illustrates another embodiment of the present invention in whichthe support surface 10 is placed upon a frame 200 which includes andintegrated device or a number of integrated components and featureswhich interact with and provide support for the features of the supportsurface 10. For instance, all or a portion of the surface controls anduser interfaces previously described with respect to the controllers120, 131, 160 and also described later herein of FIGS. 16, 17, and 18can be integrated into the one or more of the frame siderails 209, 211.In addition, the frame 200 includes an integrated control system 199including first and second connection ports 202 and 204 into which ahigh frequency chest wall oscillation device 215 can be connected viahoses 217, 219. Vest device 132 may similarly be connected to ports 202,204. In the embodiment of FIG. 22, aspects of the controller 131 of FIG.13 are incorporated into the frame control system 199. Because thesupport surface 10 includes an integrated percussion and vibration,rotational therapy, and low air loss wound care/prevention surface, thesurface/frame combination can provide a plurality of healthcare featuresin an integrated surface/frame combination.

FIG. 23 illustrates a block diagram of a bed frame or pressure reliefsurface control and communication system, such as controllers 120, 131,160, 199, including controlling and communication devices to communicatewith an integrated chest wall oscillation device such as device 132 ordevice 215. The communication system includes a liquid control display(LCD) device or other user interface device 210 which receives from auser a selection of mode, mode parameters and alarm resets. Thisinformation is displayed to the user. The parameters can include, forexample, comfort adjust, percussion, vibration, and settings for thechest wall oscillation device. The user interface screen is coupled toan algorithm control unit 212 which processes pressure relief algorithmsfor the pressure relief surface. In addition, pressure setpoints aredetermined by the algorithm control unit 212 and also algorithm controlunit 212 also processes patient position monitoring, motion monitoring,and controls a compressor. The unit 212 also communicates with the chestwall oscillation device, power printed circuit board (PCB) and providesthe control settings for the chest wall oscillation device.

The algorithm control unit 212 communicates and is coupled to the chestwall oscillation device power board 214 by a connection 224, describedfurther below. The power board 214 receives amplitude and frequencysignals and directly stimulates the air generator for the chest walloscillation device. The power board 214 also provides feedback to thealgorithm control unit 212.

An air control board 216, which can be located within the pressurerelief surface 10 or which can be located in one or more of thepreviously described controllers, is also coupled to the algorithmcontrol unit 212. The air control board 216 receives pressure setpointswhich have been set in the algorithm control unit 212 as well ascontrols the valves in response to instructions either provided by thealgorithm control unit 212 or which have been set by a user at the userinterface or LCD 210. The air control board 216 also generates requeststo the algorithm control unit 212 to turn the pump ON and OFF whichcontrols the pressure in the individual air cushions or bladders.

The support surface 10, as previously described, includes pressuresensing or force sensing transducers 218. These pressure sensing orforce sensing transducers 218 are coupled to a multiplexor hub 220 whichis, in turn, coupled to the algorithm control unit 212. The multiplexorhub 220 receives data from the transducers or sensors and retransmitsthe data on a bus which is located in the communication system describedin FIG. 23. The bus is a network bus and the network can be of one ormore types, including an ECHELON network and/or controller area network(CAN). To provide communication between the bed frame and various otherdescribed features, a gateway device 222 receives data from the bedframe first network and provides information on a second network. Thesecond network transmits signal information such as head angle, siderail status, side rail button, switch presses, and patient weight. Thefirst network in the described embodiment can include an ECHELON networkand the second network can include a CAN.

Interfacing an airway clearance system as a component in the mattresssystem may reduce the number of components required to be provided inthe airway clearance system controller or eliminate the need for aseparate controller. For instance, a local display may not be requiredat the airway clearance controller since the mattress controller displaycan be used to show airway clearance information and controls. Also,power and motor control may be shared by the two systems. This combinedarchitecture requires isolation and grounding issues to be addressed.

Accordingly, connection 224 may include an AC isolation transformer andbe configured to use the local ground as the system reference. Forexample, a 5 Amp AC isolation transformer may be used to isolate theairway clearance system board 214 from the AC supply, and allow theconnection of the airway clearance system board 214 to the mattresssystem ground. If an isolation transformer is used, and an additionalpower relay is used to control the power to the airway clearance systemboard 214, Table 1 illustrates signals that may be used to communicatefrom the algorithm board 212 to the airway clearance system board 214.

TABLE 1 SIGNAL TYPE DESCRIPTION BLOWER_REQ OUT PWM to DC signal -control blower speed BLOWER_HALL IN Hall sensor - blower motor speedDIAPHRAGM_REQ OUT PWM to DC signal - control diaphragm speedDIAPHRAGM_HALL IN Hall sensor - diaphragm motor speed POWER_RELAY OUTRelay control for VEST power relay VEST_PRESENT IN VEST system ispresent/powered signal GND GROUND Signal ground - mattress side

The POWER_RELAY signal may be used to power the airway clearance system,when requested, and the VEST_PRESENT may be used to verify that theairway clearance system is present and powered. The BLOWER_REQ signalscontrol the blower motor voltage, and the BLOWER_HALL returns the motorspeed. The DIAPHRAGM_REQ signals control the blower motor voltage, andthe DIAPHRAGM_HALL returns the motor speed. Software algorithmscorrelate the speed and pressure.

An additional input to the algorithm processor 212 may also be needed,to detect when the airway clearance system air supply is connected tothe mattress air system, rather than the actual airway clearance.

Connection 224 may alternatively include opto isolators and mechanicalisolation. Optically isolated signals may be used to provide the neededairway clearance system isolation from the AC system. This configurationallows the airway clearance system board 214 to remain directlyconnected to the AC supply, and provides an interface with optoisolators in each direction to provide an isolated communication pathbetween the algorithm board 212 and the airway clearance system board214. This approach may require a level of mechanical isolation to ensureisolation. A relay controlled by the algorithm board 212 may be providedbetween the AC source and the airway clearance system board 214, foradditional safety and to remove power to the airway clearance systemwhen not in use. A signal indicates the connection and/or powering ofthe airway clearance system board 214.

If the opto isolator approach is used, and an additional power relay isused to control the power to the airway clearance system board, Table 2illustrates signals that may be used to communicate from the algorithmboard 212 to the airway clearance system 214.

TABLE 2 SIGNAL TYPE DESCRIPTION +5 V POWER Interface power - mattressside BLOWER_REQ OUT PWM to DC signal - control blower speed BLOWER_HALLIN Hall sensor - blower motor speed DIAPHRAGM_REG OUT PWM to DC signal -control diaphragm speed DIAPHRAGM_HALL IN Hall sensor - diaphragm motorspeed POWER_RELAY OUT Relay control for VEST power relay VEST_PRESENT INVEST system is present/powered signal GND GROUND Signal ground -mattress side

The POWER_RELAY signal is used to power the airway clearance system,when requested, and the VEST_PRESENT is used to verify that the airwayclearance system is present and powered. The BLOWER_REQ signals controlsthe blower motor voltage, and the BLOWER_HALL returns the motor speed.the DIAPHRAGM_REQ signals controls the blower motor voltage, and theDIAPHRAGM_HALL returns the motor speed. Software algorithms correlatethe speed and pressure. Each side of the interface provides local +5Vpower and ground.

As additional input to the algorithm processor 212 may also be needed,to detect when the airway clearance air supply is connected to themattress air system, rather than the actual airway clearance unit.

The opto isolators and relay may be located on the same circuit board,and may be associated with the airway clearance board 214 to minimizethe exposure of the circuitry at a high voltage.

Two possible configurations for the mattress—airway clearance systeminterface are described above. Each approach has associated pro andcons. The opto isolated approach may have a lower electrical cost, butmay have an increased mechanical cost to ensure sufficient airwayclearance system isolation. The isolation transformer approach mayprovide a simpler mechanical design and better isolation, but may havean additional cost associated with the isolation transformer. The costand risk associated with each approach will need to be evaluated todetermine the best system approach for a particular implementation ofthe present invention.

The airway clearance system board interface is designed to communicatewith the user interface board 210 in close proximity. If the cabledistance between the algorithm board 212 and the airway clearance systemboard 214 is a significant distance, signal conditioning may berequired, using digital signals, and an interface board may need to belocated physically closer to the airway clearance system board 214. Lowvoltage drivers, or RS232 drivers may be used to boost the signal level.The PWM to DC filtering should be done close to the airway clearancesystem board 214 to minimize noise on this signal. If the opto isolatedapproach is used, then the signals between the daughter board and airwayclearance system board may need additional optical elements.

FIG. 24 illustrates one embodiment of a user interface screen which canbe used on any of the previously described controllers and interfaces aswell as with the bed frame described herein with reference to FIG. 22,where the interface can be embodied or incorporated into a siderail,head board, and/or footboard. As illustrated in FIG. 24, the userinterface screen 300 can include a variety of selectors which can betouch screen selectors, pressure sensitive buttons, and/or mechanicalswitches. The features which can be accessed from the user interfacescreen of FIG. 24 via selectors include a standard operating mode 302,an Opti-Rest mode 304, a rotation mode 306, an airway clearance systemmode 308, a percussion mode 310, a vibration mode 312, a maximum inflatemode 314, a turn assist mode 316, and a cardio pulmonary resuscitation(CRR) assist mode 318. In addition, start and stop buttons 320, 322 aswell as back 332 and edit buttons 324 are available. Likewise, the userinterface screen can be used to access other therapy and controls 326,setting alarms 328, and settings for a variety of features includingpressure settings 330.

FIG. 25 illustrates one example of a user interface screen 400 wherepercussion and vibration parameters can be set for the mattress support10. While FIG. 24 illustrates a single selector 310 for percussion and asingle selector 312 for vibration, the user interface screen of FIG. 24may alternatively or in addition include a single button for bothpercussion and vibration (P&V), which upon selection accesses the userinterface screen of FIG. 25.

The user interface screen 400 of FIG. 25 enables an individual to selectpercussion therapy only 402, vibration therapy only 404, or bothpercussion and vibration therapy 406 with a P & V selector. In addition,the frequency 408, 416 intensity 410, 418 and duration 412, 420 can beset for percussion and/or vibration by selecting or activating a changeselector 414, 422, respectively. The change selectors 414, 422 access asecond user interface screen (not shown) where frequency, intensity, andduration can be selected or changed for the percussion and/or vibrationtherapy. Once the settings for frequency and/or vibration have beenchanged, the selected values are displayed on the user interface screenof FIG. 25. For instance, in the illustrated embodiment, percussionfrequency 408 and vibration frequency 416 are selected as a function ofbeats per second (bps), percussion intensity 410 and vibration intensity418 are selected as being a low, medium, or high intensity, andpercussion duration 412 and vibration duration 420 are selected as avalue based on the number of minutes desired for the duration to occur.The percussion and vibration screen 400 of FIG. 25 also enables the userto select and to change the values for continuous lateral rotationtherapy (CLRT) via button 424. Once button 424 is selected, thepreselected values for percussion, vibration and continuous lateralrotation therapy can be started by pressing the start selector 428. Ahelp button 430 can be activated to provide user information foradditional details and a close button 432 can be activated to close thedisplayed screen 400 and return to the screen 300 of FIG. 24.

FIG. 26 illustrates one example of a rotation user interface screen 500which has been accessed through the selection of the CLRT selector 424of FIG. 25. The turn (rotation) percentages 502, 504 can be selected fora patient at a left turn and a right turn and the pause 506, 508, 510 inminutes can be selected to place the patient at a particular positionfor the selected period of time. Additionally, a use rotation trainingbutton 512 can be used to acclimate the patient to continuous lateralrotation therapy. By selection of this particular selector 512, theangle of rotation therapy is gradually increased to the maximum turnwhich has been selected. A rotation monitor 514 is also included andindicates the amount of time the patient has been under the rotationtherapy in the most previous 24 hours.

If the airway clearance selector 308 of FIG. 24 is selected, the userinterface screen 600 of FIG. 27 is displayed. At this screen, a user canselect the pulse frequency 602 in beats per second, the intensity 604 ofpressure applied by the airway clearance system to the chest of apatient, and time duration 608 of the airway clearance therapy inminutes. Screen 600 also includes a help/training graphic and/or visualfeature 612 to aid the caregiver in administering the airway clearancetherapy.

FIG. 28 illustrates a therapy reminder user interface screen 700 inaccordance with the present invention. By selecting the therapy andcontrols selector 326 of FIG. 24, the therapy reminder screen 700 ofFIG. 28 is displayed. At this screen, a user can select reminders 702,706, 710 for the therapies of rotation, percussion and vibration, andairway clearance. The length of time between the last therapy sessionand the reminders is specified at areas 704, 708, 710 for each of therotation, percussion and vibration, and airway clearance therapies,respectively. This length of time is adjusted using button 714 toincrease the delay and by using button 716 to decrease the delay. Otherreminders are also possible. For instance, it is possible to provide analert if rotation has been stopped for a selected period of time, whichin this case is shown to be 90 minutes. Likewise, percussion andvibration as well as airway clearance reminders can be selected forevery eight hours, for instance. Once the selected time period haselapsed, an alarm, such as a visual or aural alert is made to indicatethat it is time to provide the therapy. While the figures show remindersand other parameters configured for each of the available therapies, itwill be understood by those skilled in the art that any combination ofthe available therapies may be activated or deactivated at a given time.

By selecting the alarm selector 328 of FIG. 24, an alarm settings userinterface screen 800 as illustrated in FIG. 29 is displayed. Uponselection of this particular interface screen 800, a user can select abed exit alarm for a sitting up position 802, a sitting on edge of bedposition 804, or an out of bed condition 806. For instance, if a patientsits up and the sitting up selector 802 has been selected, whenever apatient sits up an audio or visual alarm will be activated. The volumelevel of the audio alarm which is activated can be selected by an alarmvolume selector 812 which includes a negative or down volume selector810 and a positive or up volume selector 812. If the bed exit alarm ofsitting on edge 804 has been selected, even though a patient sits up inbed, an alarm will not sound. However, when a patient moves to sittingon the edge of the bed, an alarm will sound or otherwise be activated.Should the user select the out of bed condition alarm 806, a patient ina sitting up position or a sitting on edge position will not trigger thealarm. Only when a patient exits the bed will an alarm be activated. Anedge lying alarm 808 is also included which indicates to a user that apatient is lying on the bed and is close to an edge which can be acondition that is not desirable.

FIG. 30 illustrates a therapy log user interface screen 900 which can beselected by the therapy and controls button 326 of FIG. 24. The therapylog user interface screen 900 can be used to review data which has beenstored regarding the various selected therapies over a period of time,for instance, 24 hours as illustrated in FIG. 30. The details ofrotation 902, head elevation 904, percussion and vibration 906, alarmsactivated 908, and airway clearance 910 can be displayed. A visual bargraph of rotation is shown in area 902 as well as the actual hours andminutes of time a patient has experienced rotation. Head elevation isalso shown in area 904 as a series of icons which show a horizontalstate, a partially elevated state and a more highly elevated state orsitting up state for the patient. Percussion and vibration isillustrated in area 906 by a bar located along a time line of zero to 24hours to indicate when the percussion and vibration has been applied toa patient. In this instance, three treatments have been applied over aperiod of 24 hours. In the alarms portion 908 of the user interfacescreen 900, one alarm occurred over the 24 hour period as shown by the24 hour time line and as indicated by the statement of one alarm. In theairway clearance portion 910 of the therapy log 900, there have been notreatments over the last 24 hours. However, the portion of the airwayclearance area 910 indicates that the last treatment was five days ago.Consequently, if there has been no airway clearance procedures performedover the last 24 hours, the system can display when the last treatmentoccurred. It is also possible to display similar information for theother four displayed functions. For instance, if there have been nopercussion and vibration treatments over the last 24 hours, it ispossible to display the number of days which has elapsed since the lasttreatment.

Although the invention has been described in detail with reference tocertain preferred embodiments, variations and modifications exist withinthe scope and spirit of the present invention. For instance, while thefigures illustrate a surface including a plurality of upstanding aircushions having a cylindrical shape, other air cushions are within thescope of the present invention. Air bladder assemblies havinghorizontally disposed or transversely disclosed bladders are within thescope of the invention. Other pressure or force sensing transducers thanthose disclosed herein are also within the scope of the presentinvention. For additional details of such bladders or sensingtransducers, please see U.S. Provisional Patent Application Ser. No.60/821,494, the disclosure of which is incorporated herein by thisreference.

1. A patient support surface comprising: a cover defining an interiorregion; a layer of three dimensional material, located at the interiorregion, the three-dimensional material including a network ofthermoplastic fibers; an air circulation device disposed adjacent thelayer of three dimensional material; and at least one of a percussiondevice and a vibration device, located at the interior region.
 2. Thepatient support surface of claim 1 further comprising a bladder,disposed at the interior region, the bladder being inflatable andadapted to provide at least one of turning and rotation.
 3. The patientsupport of claim 2, further comprising a plurality of cushions, disposedat the interior region.
 4. The patient support of claim 3, furthercomprising a plurality of sensors, disposed at the interior region, tosense at least one of a pressure and a force.
 5. A patient supportsurface comprising: a cover defining an interior region; a layer ofthree dimensional material, located at the interior region, thethree-dimensional material including a network of thermoplastic fibers;an air circulation device disposed adjacent the layer of threedimensional material; and a hose, located at the interior region,including at least one connector adapted to couple to an externaldevice.
 6. The patient support surface of claim 5, further wherein thecoupled is adapted to couple to an airway clearance device.
 7. Thepatient support surface of claim 5, further comprising a plurality ofcushions, disposed at the interior regions.
 8. The patient support ofclaim 7, further comprising a plurality of sensors, disposed at theinterior region, to sense at least one of a pressure and a force.
 9. Ahospital bed comprising: a frame, to support a patient; and a supportsurface; located on the frame, the support surface including a coverdefining an interior region, a layer of three dimensional material,located at the interior region, the three-dimensional material includinga network of thermoplastic fibers, an air circulation device disposedadjacent the layer of three dimensional material; and at least one of apercussion and a vibration device, located at the interior region. 10.The hospital bed of claim 9, wherein the surface further comprises abladder, disposed at the interior region, the bladder being inflatableand adapted to provide at least one of turning and rotation.
 11. Thehospital bed of claim 10, wherein the frame comprises an integrateddevice, including a coupler adapted to couple to an airway clearancedevice.
 12. The patient support surface of claim 11, further comprisinga plurality of cushions, disposed at the interior region.
 13. Thepatient support of claim 12, further comprising a plurality of sensors,disposed at the interior region, to sense at least one of a pressure anda force.
 14. A patient support surface having a head end and a foot end,comprising: a cover defining an interior region; a layer of threedimensional material, located at the interior region, thethree-dimensional material including a network of thermoplastic fibers;an air circulation device disposed adjacent the layer of threedimensional material; and a head elevation device, located at the headend of the patient support surface, the head elevation device includinga support surface to elevate the head end of the patient supportsurface.
 15. The patient support surface of claim 14, further comprisingat least one of a percussion device and a vibration device, located atthe interior region.
 16. The patient support surface of claim 15 furthercomprising a bladder, disposed at the interior region, the bladder beinginflatable and adapted to provide at least one of turning and rotation.17. The patient support of claim 16, further comprising a plurality ofcushions, disposed at the interior region.
 18. The patient support ofclaim 17, further comprising a plurality of sensors, disposed at theinterior region, to sense at least one of a pressure and a force.